1215203146 NPI number — BERKS HYPNOSIS AND COUNSELING SERVICES LLC

Table of content: EDIZ F. COSAR MD (NPI 1467442798)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1215203146 NPI number — BERKS HYPNOSIS AND COUNSELING SERVICES LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BERKS HYPNOSIS AND COUNSELING SERVICES LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1215203146
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/26/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
148 ROBBY DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LEESPORT
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19533-9434
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-916-3594
Provider Business Mailing Address Fax Number:
610-926-9179

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5 S CENTRE AVE
Provider Second Line Business Practice Location Address:
SUITE A5
Provider Business Practice Location Address City Name:
LEESPORT
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19533-8653
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-916-3594
Provider Business Practice Location Address Fax Number:
610-926-9179
Provider Enumeration Date:
03/26/2012

Additional Information

Authorized Official

Authorized Official Last Name:
ARENA
Authorized Official First Name:
DAVID
Authorized Official Middle Name:
ADAM
Authorized Official Title or Position:
PRESIDENT/OWNER
Authorized Official Telephone Number:
215-939-8429

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X , with the licence number:  PC005641 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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